The objective of this study was to understand experiences of patients, families and clinicians with the Footprints Project - a tool used to counter the unintentional dehumanisation of critically ill patients in the intensive care unit (ICU).

Qualitative descriptive study.

29-bed university-affiliated ICU.

Of 66 participants, 7 were survivors of critical illness, 19 were family members of survivors or decedents and 40 were clinicians representing 10 different professions.

The Footprints Project uses a written form to record personal details about each patient, then excerpts are transcribed onto a whiteboard in each patient’s room. Patients and family members were invited to participate in semistructured interviews or focus groups after ICU discharge (October 2024–August 2025). Clinicians were invited by email (January 2025–May 2025). Focus groups and interviews were audio-recorded, transcribed and anonymised.

Perspectives and experiences of patients, family members and clinicians.

Data collection was primarily in-person for patients and families (17 of 26, 65.4%), and virtual for clinicians (36 of 40, 90.0%). Qualitative content analysis of transcripts revealed three categories related to identity, inclusivity and impact. Footprints was experienced as a tool to highlight personhood by bringing patients into view, individualising conversations and encouraging use of preferred names. Features fostering inclusivity include increasing awareness of vulnerabilities, facilitating culturally-sensitive care and helping to avoid errant assumptions. Patients valued being acknowledged as a person. Families valued recognition of their loved one as an individual. Clinicians found shared humanity through Footprints. Participants identified barriers to consistent use, underscoring implementation challenges; they also shared ideas for more intentional, consistent utilisation.

The Footprints Project was viewed as a relational tool, reflecting a patient-facing approach to person-centred, family-partnered care that supports humanism in healthcare. Future work should include structured implementation strategies and assess how Footprints can be sustained and embedded into practice.

This study aims to estimate the rate of recruitment of participants.

This is a pilot, multicentre, double-blind, placebo-controlled, randomised controlled trial of oral oxycodone and sublingual placebo vs sublingual buprenorphine and oral placebo for postoperative pain management for 7 days after pelvic exenteration.

Patients will be recruited from three metropolitan quaternary referral centres that offer advanced gastrointestinal surgery in Australia.

The inclusion criteria will be patients over the age of 18 years undergoing pelvic exenteration surgery and exclusion criteria are previous adverse events related to the study drugs, currently requiring monoamine oxidase inhibitor medications and if epidural analgesia is planned in the perioperative period.

Enrolled patients will undergo pelvic exenteration surgery and be initiated postoperatively on patient-controlled analgesia. In the postoperative period, when clinically appropriate to take oral medications, patients will be commenced on trial analgesia for 7 days. Participants will be randomised to receive either oral active oxycodone 5–10 mg up to 3 hourly as required (with sublingual placebo) or sublingual active buprenorphine 200–400 mcg 3 hourly as required (with oral placebo).

The primary outcome measure is the rate of recruitment over a 6-month period. Secondary outcomes include an assessment of missing data, protocol adherence and acceptability of the trial to participants.

The trial received ethics approval from Sydney Local Health District, Royal Prince Alfred Hospital Human Research Ethics Committee (No: X25-0128 & 2025/ETH01058). The results of the study will be disseminated by publication and presentation at local annual scientific meetings in Australia.

The study protocol is prospectively registered at the Australian New Zealand Clinical Trials Registry (ANZCTR) (www.anzctr.org.au; ACTRN12625000901404).

Treatment for women with endometriosis is only partially or temporarily effective. Moreover, medical hormonal treatment is associated with debilitating side effects and interferes with fertility, while surgery has a relatively high risk of complications. Meanwhile, women with endometriosis show increasing interest in implementing lifestyle interventions to alleviate symptoms and improve health-related quality of life (HRQoL). Integrating these lifestyle interventions can provide a holistic approach to the treatment of this debilitating disease. However, scientific evidence supporting the effectiveness of these interventions is limited. This study is designed to investigate the effectiveness of two lifestyle interventions and the combination of both: an anti-inflammatory diet intervention (AIDI) could improve immune cell function and reduce inflammation, resulting in improved HRQoL and alleviating pain. In addition, the integration of cognitive behavioural therapy (CBT) aims to provide insight into pain mechanisms and coping with pain, and to assist in sustaining dietary adjustments.

The Pain in Endometriosis And the Relation to Lifestyle (PEARL) study is a five-arm randomised controlled trial with a pre-post factorial design with two factors: an AIDI and CBT. The study population will consist of 250 premenopausal women, of whom 200 are diagnosed with endometriosis and experience pain symptoms and 50 are healthy controls (HC). Women with endometriosis will be recruited from one academic tertiary and five secondary hospitals in the Netherlands. They will be randomised (1:1:1:1) among four intervention groups: standard care (SC) (SC group), SC and an AIDI (SC + AIDI group), SC and CBT (SC + CBT group), and SC, AIDI and CBT (SC + AIDI + CBT group). Women with endometriosis will visit the hospital twice during the intervention period, at the start (T0) and end (T2) of the 13-week intervention period. HC will not undergo any of the interventions and will have one hospital visit (T0). Participants will complete questionnaires regarding pain symptoms, HRQoL, physical activity level, sleep, diet quality, pain cognitions, and stress at T0 and T2. Furthermore, they are instructed to collect menstrual effluent, a vaginal swab and a faecal sample. During the study visits, peripheral blood will be drawn and scalp hair samples will be taken. The primary outcome is average pain, measured using a numerical rating scale. Secondary outcomes focus on HRQoL, inflammation, immune system characteristics, vaginal- and gut microbiome, and hair cortisol levels. These are considered to reflect potentially underlying mechanisms of the effect of both interventions on the primary outcome. Biological samples and questionnaires of women with endometriosis and HC will be compared to establish the differences in secondary outcomes.

This study protocol has been approved (approval number: NL86247.091.24) by the METC Oost-Nederland from Radboud University Medical Centre on July 11, 2024. Prior to participation, participants are required to provide informed consent. The results will be widely disseminated through scientific peer-reviewed journals, and presentation to a broad audience in scientific meetings, congresses, patient meetings, as well as in policy-relevant forums.

NCT06332560.

Sedation is commonly used in critically ill patients to facilitate procedures and care as well as provide comfort but can carry risks such as delirium and prolonged mechanical ventilation. Although current guidelines advocate for light sedation, sedation practices are influenced by clinicians’ subjective interpretations. Patients and families may experience distress and unmet needs, and little is known about their perspectives and experiences in the context of contemporary light sedation practices.

This study aimed to understand the perceptions and experiences of both patient and family members in the intensive care unit (ICU) of current sedation practices.

Canadian, closed, mixed ICU setting.

Critically ill adult patients and adult family members.

Patients and family members were interviewed, using a semi-structured interview questionnaire, and Braun and Clarke inductive thematic analysis was used to identify themes and subthemes in the data.

We conducted semi-structured interviews with 10 family members and 10 patients. Family members and patients reported that sedation was needed for patient comfort. Family members also described the need for sedation for patient and staff safety, as well as their own comfort. While both groups described sedation as necessary for enduring the medical procedures in the ICU, both groups reported concerns of sedation use, including negative physiological and cognitive patient outcomes. Patients and family members also recommended strategies for improving how sedation use is communicated in the ICU.

Perceptions and experiences of patient and families with sedation care practices in the ICU were multifaceted with both positive and negative outcomes reported including psychological and emotional concerns with sedation use. Key recommendations were provided for improving sedation practices with families emphasising the need for family-centred care and patients highlighting the need for self-determination.

To identify and prioritise the most appropriate (de)prescribing interventions in inpatient and outpatient hospital care to advance environmentally sustainable healthcare.

A modified RAND Delphi study.

Inpatient and outpatient hospital care in the Netherlands.

The Delphi panel consisted of 63 participants, comprising 36 physicians and 27 pharmacists working in Dutch hospitals.

Consensus on the appropriateness of (de)prescribing interventions for frequently used medications in inpatient and outpatient hospital care to advance environmentally sustainable healthcare and the prioritisation of interventions per care setting (inpatient/outpatient) and intervention type (deprescribing/sustainable dosage form), culminating in a top 20.

51 (de)prescribing interventions were identified for 18 medication classes, for which consensus on appropriateness was reached for 42 (82%). The top 20 highest ranked interventions were identified, starting with switching from intravenous to oral administration of paracetamol, stopping chronically used proton pump inhibitors without indication and initiating antibiotics orally in case of good bioavailability.

Most (de)prescribing interventions were considered appropriate for advancing sustainable medication use, highlighting support for their potential implementation to reduce the environmental burden of healthcare.